Power of the Pulpit: Engaging Spiritual Leaders in End-Of-Life Care Conversations

Posted on 10/09/2018

In the following interview, Rev. Rosemary Lloyd, Faith Advisor to The Conversation Project, shares how enlisting spiritual leaders in an initiative called Conversation Sabbath (October 26 – November 4) can spur important end-of-life discussions in faith communities.

How did Conversation Sabbath start and how has it evolved?

Four years ago, we started a project to engage faith communities in conversations about end-of-life wishes. Our message was that people shouldn’t be afraid to embrace the reality of their mortality. We intentionally scheduled Conversation Sabbath from late October to early November with the goal of building anticipation for American families to engage in end-of-life conversations during the Thanksgiving holiday.

We aimed to reach 30 congregations in the Boston area (applying the Institute for Healthcare Improvement’s strategy of doing small tests of change first). Once we met that goal, we decided to expand our efforts. In subsequent years, we started our campaign earlier and increased our outreach through newsletters and community calls. We’ve reached out to community health organizations and explained that faith is an important component of how people make end-of-life care decisions. This year, many health care systems have told us they want to promote the Conversation Sabbath in their communities.

The program has spread across the country, and we’ve found surprising places where this has become popular.

Is there any sort of follow-up or feedback that occurs between congregations and staff working on Conversation Sabbath?

Once people register online, we send them an email providing resources to share with their congregations. At the end of the program, we reach out again and ask: How did it go? Were there any stories that emerged?

Most of the feedback we receive comes in the form of stories from participants. In one instance, we were able to turn a powerful testimonial from a physician into a blog post called “The Doctor and the Rabbi.” Sometimes, congregations that didn’t officially register will tell us afterward that they participated in Conversation Sabbath. Thus, this project has grown in ways that we can’t always measure.

Why is engaging spiritual leaders so important?

Conventional wisdom tells us that people are afraid to talk about death, but we’ve learned that they want to talk about it — they just need an invitation. Congregations are pre-existing groups of people who share similar values and strive to lead the best lives possible. Spiritual leaders can guide them toward having end-of-life conversations by sharing exemplars in their own faith traditions who candidly faced their deaths. When people embrace the reality of their mortality, this leads to reflection and opens opportunities for them to say, “I’m sorry,” “thank you,” or “I love you.” The clergy can play a significant role in that process. We want people to talk about what matters most to them about their lives, ethics, and relationships. People are stronger and more prepared for those difficult end-of-life moments if they’ve had these conversations; it’s sort of like emergency preparedness.

Is there a story you can tell that helps illustrate why engaging faith communities in this work is so important?

When the ministers at Bethel AME Church in Jamaica Plain, Massachusetts chose to participate in Conversation Sabbath four years ago, they demonstrated to their congregation an openness to the conversation and a willingness to set aside fear.The congregation subsequently developed a program called “Planning Ahead,” which begins with an annual invitation to join small groups that discuss advanced care planning. They utilize theConversation Starter Kit, learn about health care proxy paperwork in Massachusetts, and watch a documentary about families who are deciding whether to end curative care in the intensive care unit. Most importantly, they celebrate one another for boldly engaging in a topic that initially seems somber but is actually life-affirming. These conversations prepare us to go faithfully and peacefully, instead of leaving behind fractures in our families or keeping them in the dark about what matter most to us.